| NPI | 1619948213 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX L5468) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 64904) |
| 208M00000X Hospitalist (Licence: ND 14459) | |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2023-12-28 |